Diabetes: Pevent complications, spend less

The majority of patients who are admitted to hospitals for treatment of diabetes have to spend out of their savings, and under 10 per cent are covered by insurance, a recent study published in the Journal of the Association of Physicians of India (JAPI) points out.

About 48 per cent of patients admitted to hospitals for treatment of diabetes or for complications arising out of diabetes have to dig into their personal savings to pay for their treatment costs. The study, authored by Satyavani K, Hemalatha K, Shabana Tharkar, and Vijay Viswanathan, all from MVHospital for Diabetes and Prof. M.Viswanathan Diabetes Research Centre, is based on the experiences of 368 patients admitted to the hospital.

Clearly, patients without complications spend far lesser than those with complications do, and the hospital tab goes up by about four times for the latter group. Dr. Vijay Viswanathan says, “A substantial portion of the costs of diabetes treatment arise from treating long-term complications, particularly foot, cardiovascular and renal diseases.”

In an editorial in the same issue of JAPI, Anil Bhansali, head, department of Endocrinology, PGIMER, Chandigarh said, “With increasing life span, the complications are bound to occur …The cost of treating diabetes is enormous, as most of the patients with diabetes not only require anti-diabetic medications, but also need hypertensives, aspirin, statins and other medicines related to its complications.”

The expenditure included lab charges, medical consultations, medicines, hospital charges, medical consultations, medicines, hospital charges and charges for other investigations and transport, according to the authors.

While patients who were admitted for only control of their blood sugar level (considered the base group) spent an average of Rs. 4,493, those with foot complications spent over four times that sum, Rs. 19,020, in the study group. Persons with two complications spent Rs. 17,633 (four times higher), and patients with chronic kidney disease (Rs.12,690), cardiovascular complications (Rs. 13,135) and retinal complications (Rs. 13,922), spent three times higher.

Only 7 per cent of the group had some form of medical insurance, and this is worrying, Dr. Vijay added. “In about 12 per cent of the cases, the company the patient was employed in footed the bill, but the majority still had to take loans, mortgage or sell property to fund their hospital bills. The disease takes a larger toll, not only on the health of the individual, but also figuratively on the health of his entire family.”

The way out, Dr. Vijay said, was to keep the blood sugar levels under control. “Prevent or delay the onset of complications – that is key to managing the disease and not whittling down savings on health care costs.”

Dr. Bhansali makes the point that there is a key role for government and non governmental organisations here. “IT should be ensured that the continuous supply of medications either free of cost or at subsidised rates should be provided to all patients with diabetes.” He also recommends that an extensive education/awareness campaign on prevention all over the country.